Lederman K H, Clayton J A
J Prosthet Dent. 1983 Jul;50(1):95-100. doi: 10.1016/0022-3913(83)90173-7.
An earlier study of 50 patients with occlusions restored by fixed partial dentures indicated a high percent (68%) of TMJ dysfunction. Occlusal interferences can play a significant role in causing TMJ dysfunction. To determine the significance of occlusal interferences, occlusal splints were placed in 10 of these restored patients who had moderate to severe dysfunction. The PRI was used to detect the presence or absence of TMJ dysfunction. The PRI TMJ dysfunction scores were reduced in all 10 patients after use of the occlusal splint. Five of the patients achieved reproducible tracings (no TMJ dysfunction) during the experiment time of 7 months. The occlusion of two patients was adjusted to eliminate the need for the occlusal splint. Patients who wore the splint 24 hours a day showed a significant (0.0004 level) reduction in TMJ dysfunction. Those patients who did not wear the splint regularly or had high levels of stress had PRI scores that varied. This finding indicates that the occlusal splint is not a treatment, as its removal permits reactivation of the occlusal interference. Resolution of dysfunction did not occur until occlusal interferences were removed. The changes in PRI scores to different dysfunction categories (none, slight, moderate, and severe) for the experimental group were significant at the 0.01 level. A control group of five patients had similar pantographic tracings but no other treatment. Their PRI scores varied, but there was no significant change in PRI scores or dysfunction categories. It was concluded that occlusal interferences were active causes of TMJ dysfunction in 10 of 36 patients in a population with restored occlusions.
一项针对50例通过固定局部义齿修复牙列缺损患者的早期研究表明，颞下颌关节功能紊乱的发生率很高（68%）。咬合干扰在导致颞下颌关节功能紊乱方面可能起重要作用。为了确定咬合干扰的重要性，对其中10例有中度至重度功能紊乱的修复患者佩戴了咬合板。使用PRI来检测颞下颌关节功能紊乱的有无。在所有10例患者使用咬合板后，PRI颞下颌关节功能紊乱评分均降低。其中5例患者在7个月的实验期内获得了可重复的描记结果（无颞下颌关节功能紊乱）。对2例患者的咬合进行了调整，使其不再需要佩戴咬合板。每天佩戴咬合板24小时的患者，其颞下颌关节功能紊乱有显著（0.0004水平）减轻。那些未规律佩戴咬合板或压力水平高的患者，其PRI评分有所波动。这一发现表明，咬合板并非一种治疗方法，因为去除咬合板后咬合干扰会再次出现。直到消除咬合干扰，功能紊乱才得以解决。实验组PRI评分在不同功能紊乱类别（无、轻度、中度和重度）之间的变化在0.01水平上具有显著性。一个由5例患者组成的对照组有类似的全口曲面断层描记结果，但未接受其他治疗。他们的PRI评分有所波动，但PRI评分或功能紊乱类别没有显著变化。得出的结论是，在牙列缺损已修复的人群中，36例患者中有10例的咬合干扰是颞下颌关节功能紊乱的活跃病因。
